Movable surgical mounting platform controlled by manual motion of robotic arms

ABSTRACT

Robotic and/or surgical devices, systems, and methods include kinematic linkage structures and associated control systems configured to facilitate preparation of the system for use. One or more kinematic linkage sub-systems may include joints that are actively driven, passive, or a mix of both, and may employ a set-up mode in which one or more of the joints are actively driven in response to manual articulation of one or more other joints of the kinematic chain. In an exemplary embodiment, the actively driven joints will move a platform structure that supports multiple manipulators in response to movement of one of the manipulators, facilitating and expediting the arrangement of the overall system by moving those multiple manipulators as a unit into alignment with the workspace. Manual independent positioning of the manipulator can be provided through passive set-up joint systems supporting the manipulators relative to the platform.

BACKGROUND

Minimally invasive medical techniques are intended to reduce the amountof extraneous tissue that is damaged during diagnostic or surgicalprocedures, thereby reducing patient recovery time, discomfort, anddeleterious side effects. One effect of minimally invasive surgery, forexample, is reduced post-operative hospital recovery times. Because theaverage hospital stay for a standard surgery is typically significantlylonger than the average stay for an analogous minimally invasivesurgery, increased use of minimally invasive techniques could savemillions of dollars in hospital costs each year. While many of thesurgeries performed each year in the United States could potentially beperformed in a minimally invasive manner, only a portion of the currentsurgeries use these advantageous techniques due to limitations inminimally invasive surgical instruments and the additional surgicaltraining involved in mastering them.

Minimally invasive robotic surgical or telesurgical systems have beendeveloped to increase a surgeon's dexterity and avoid some of thelimitations on traditional minimally invasive techniques. Intelesurgery, the surgeon uses some form of remote control (e.g., aservomechanism or the like) to manipulate surgical instrument movements,rather than directly holding and moving the instruments by hand. Intelesurgery systems, the surgeon can be provided with an image of thesurgical site at a surgical workstation. While viewing a two or threedimensional image of the surgical site on a display, the surgeonperforms the surgical procedures on the patient by manipulating mastercontrol devices, which in turn control motion of the servo-mechanicallyoperated instruments.

The servomechanism used for telesurgery will often accept input from twomaster controllers (one for each of the surgeon's hands) and may includetwo or more robotic arms on each of which a surgical instrument ismounted. Operative communication between master controllers andassociated robotic arm and instrument assemblies is typically achievedthrough a control system. The control system typically includes at leastone processor that relays input commands from the master controllers tothe associated robotic arm and instrument assemblies and back from theinstrument and arm assemblies to the associated master controllers inthe case of, for example, force feedback or the like. One example of arobotic surgical system is the DA VINCI® system available from IntuitiveSurgical, Inc. of Sunnyvale, Calif.

A variety of structural arrangements can be used to support the surgicalinstrument at the surgical site during robotic surgery. The drivenlinkage or “slave” is often called a robotic surgical manipulator, andexemplary linkage arrangements for use as a robotic surgical manipulatorduring minimally invasive robotic surgery are described in U.S. Pat.Nos. 7,594,912; 6,758,843; 6,246,200; and 5,800,423; the fulldisclosures of which are incorporated herein by reference. Theselinkages often make use of a parallelogram arrangement to hold aninstrument having a shaft. Such a manipulator structure can constrainmovement of the instrument so that the instrument pivots about a remotecenter of manipulation positioned in space along the length of the rigidshaft. By aligning the remote center of manipulation with the incisionpoint to the internal surgical site (for example, with a trocar orcannula at an abdominal wall during laparoscopic surgery), an endeffector of the surgical instrument can be positioned safely by movingthe proximal end of the shaft using the manipulator linkage withoutimposing potentially dangerous forces against the abdominal wall.Alternative manipulator structures are described, for example, in U.S.Pat. Nos. 7,763,015; 6,702,805; 6,676,669; 5,855,583; 5,808,665;5,445,166; and 5,184,601; the full disclosures of which are incorporatedherein by reference.

A variety of structural arrangements can also be used to support andposition the robotic surgical manipulator and the surgical instrument atthe surgical site during robotic surgery. Supporting linkage mechanisms,sometimes referred to as set-up joints, or set-up joint arms, are oftenused to position and align each manipulator with the respective incisionpoint in a patient's body. The supporting linkage mechanism facilitatesthe alignment of a surgical manipulator with a desired surgical incisionpoint and targeted anatomy. Exemplary supporting linkage mechanisms aredescribed in U.S. Pat. Nos. 6,246,200 and 6,788,018, the fulldisclosures of which are incorporated herein by reference.

While the new telesurgical systems and devices have proven highlyeffective and advantageous, still further improvements are desirable. Ingeneral, improved minimally invasive robotic surgery systems aredesirable. It would be particularly beneficial if these improvedtechnologies enhanced the efficiency and ease of use of robotic surgicalsystems. For example, it would be particularly beneficial to increasemaneuverability, improve space utilization in an operating room, providea faster and easier set-up, inhibit collisions between robotic devicesduring use, and/or reduce the mechanical complexity and size of thesenew surgical systems.

BRIEF SUMMARY

The following presents a simplified summary of some embodiments of theinvention in order to provide a basic understanding of the invention.This summary is not an extensive overview of the invention. It is notintended to identify key/critical elements of the invention or todelineate the scope of the invention. Its sole purpose is to presentsome embodiments of the invention in a simplified form as a prelude tothe more detailed description that is presented later.

The present invention generally provides improved robotic and/orsurgical devices, systems, and methods. Kinematic linkage structures andassociated control systems described herein are particularly beneficialin helping system users to arrange the robotic structure in preparationfor use, including in preparation for a surgical procedure on aparticular patient. Exemplary robotic surgical systems described hereinmay have one or more kinematic linkage sub-systems that are configuredto help align a manipulator structure with the surgical work site. Thejoints of these set-up systems may be actively driven, passive (so thatthey are manually articulated and then locked into the desiredconfiguration while the manipulator is used therapeutically), or a mixof both. Embodiments of the robotic systems described herein may employa set-up mode in which one or more joints are actively driven inresponse to manual articulation of one or more other joints of thekinematic chain. In many embodiments, the actively driven joints willmove a platform structure that supports multiple manipulators inresponse to manual movement of one of those manipulators, facilitatingand expediting the arrangement of the overall system by moving thosemultiple manipulators as a unit into an initial orientational and/orpositional alignment with the workspace. Input of the manipulatormovement and independent positioning of one, some or all of themanipulators supported by the platform can optionally be providedthrough a passive set-up joint systems supporting one, some, or all ofthe manipulators relative to the platform. Optionally, manual movementof a set-up joint linkage disposed between a manipulator and theplatform can result in a movement of the platform, with the platform(and the other manipulators supported thereby) following manual movementof the manipulator with a movement analogous to leading a horse by thenose.

Thus, in a first aspect, a method for preparing for robotic surgery isprovided. The method includes sensing an input displacement of a firstlink of a first robotic manipulator from an initial position to adisplaced position relative to an orienting platform, calculating amovement of a set-up structure linkage in response to the inputdisplacement so that the first link of the first manipulator returnstoward the initial position, and driving the set-up structure linkageper the calculated movement. The input displacement may result from amanual articulation of the set-up joint linkage supporting the firstmanipulator so that the first link moves toward a desired alignment witha surgical site. The set-up structure linkage may support the orientingplatform and the orienting platform may support the first manipulatorvia the set-up joint linkage and a second manipulator.

In many embodiments of the method for preparing for robotic surgery, themethod can include maintaining a fixed pose of the first manipulatorduring the input displacement so that the first manipulator moves as asubstantially solid body. In this embodiment, the set-up structure maybe driven while a user manually moves the first link toward the desiredalignment with the surgical site.

In additional embodiments of the method for preparing for roboticsurgery, the first link may have a preferred positional relationshiprelative to the orienting platform prior to the manual movement. Thecalculated movement of the set-up structure linkage may then move theorienting platform so as to return toward the preferred positionalrelationship during the manual movement. The preferred positionalrelationship may be used to help maintain a desired range of motion ofthe first manipulator relative to the orienting platform.

In further embodiments of the method for preparing for robotic surgery,the movement of the set-up structure linkage may be calculated using avelocity of the first link relative to the orienting platform during theinput displacement. The driving of the set-up structure linkage maydiminish this velocity. The method may further include reducing thevelocity of the first link relative to the orienting platform by asaturation threshold when the velocity exceeds the saturation threshold.In other exemplary embodiments, the calculated movement may resilientlyurge the set-up structure away from a configuration when the velocity ofthe first link relative to the orienting platform moves the set-upstructure toward an undesirable motion-limiting configuration. In otherembodiments, the driving of the setup structure may occur in a platformmovement mode. The mode may be entered when the set-up linkage structureapproaches or reaches an undesirable motion-limiting configuration.

In many embodiments, the method for preparing for robotic surgery mayinclude instrument holders coupled to each of the manipulators. Themanipulators may be configured to support an associated surgicalinstrument mounted to the instrument holder relative to a manipulatorbase. The manipulators may be further configured to insert theassociated surgical instrument along an insertion axis into a patientthrough an associated remote center of manipulation (RC). Additionally,the manipulators may be configured to rotate the instrument holderaround one or more axes that intersect the associated RC. Also the axesmay be transverse to the insertion axis. For example, a first and secondmanipulator axis may intersect the associated RC, and each may betransverse to the insertion axis. Moreover the second manipulator axismay be transverse to the first manipulator axis.

In many embodiments, the set-up structure linkage may include a mountingbase, a column, a member, and an extendable boom. The column may beslideably coupled with the mounting base. Additionally, the column maybe selectively positioned relative to the mounting base along a firstsupport axis that is vertically oriented. The member may be a boom basemember rotationally coupled to the column through a shoulder joint. Themember may be selectively oriented relative to the column around asecond support axis that is vertically oriented. The extendable boom maybe slideably coupled with the member to selectively position theextendable boom relative to the member along a third support axis thatis horizontally oriented. The orienting platform may be rotationallycoupled to the extendable boom member. In some embodiments, the firstlink is the instrument holder or is adjacent thereto. The calculatedmovement may include a movement of a plurality of joints of the set-upstructure linkage and the plurality of joints may be driven per thecalculated movement so that the first manipulator is well-conditioned.In other exemplary embodiments, the manual movement may align theassociated first RC of the first manipulator with a desired first RC ofthe surgical site. The driven movement of the set-up structure linkagemay move the associated RC of the second manipulator toward a seconddesired RC of the surgical site.

In additional embodiments, the method for preparing for robotic surgerymay include a manipulator with an orienting platform movement inputmounted adjacent to the first link. The movement input may normally bein a first state and manually actuatable to a second state. Theorienting platform may not move in response to movement of the firstlink when the movement input is in the first state. Further, the methodfor preparing for robotic surgery may include mounting a cannula to thefirst manipulator after the manual movement. The cannula may provideaccess to an internal surgical site for a surgical instrument supportedby the first manipulator. This exemplary embodiment may further includeinhibiting movement of the orienting platform in response to themounting of the cannula. The exemplary method may use joint brakes toinhibit movement along joints of the set-up structure linkage inresponse to the movement input being in the first state or in responseto the mounting of the cannula to the first manipulator.

In a second aspect, another method for preparing for robotic surgery isprovided. The method includes manually moving a first manipulator sothat a first link of the manipulator moves toward a desired alignmentwith a surgical site, sensing an input displacement of the first linkfrom an initial position to a displace position relative to theplatform, calculating a movement of a linkage in response to the inputdisplacement, driving the linkage per the calculated movement so thatthe platform follows the first link, and treating tissue at the surgicalsite by driving the first and second manipulators. The calculatedmovement may be such that the first link of the first manipulatorreturns toward the initial positional relationship relative to theplatform. The linkage may support the platform and the platform maysupport the first and second manipulator.

In another aspect, a system for robotic surgery is provided. The roboticsurgery system includes a platform supporting the bases of manipulators,a support structure supporting the platform and a processor coupling themanipulators to the support structure. A first and second roboticmanipulator supported by the platform may have a manipulator linkageincluding a first link and a drive system coupled to the manipulatorlinkage so as to drive the first link during surgery. The supportstructure may include support linkage including a base and a drivesystem coupled to the support linkage so as to drive the platformrelative to the support structure base. The processor may have aplatform movement mode which calculates a set-up command in response toa manual movement of the first link of the first manipulator relative tothe platform. The processor may then transmit a platform command to thesupport structure so as to move the platform and the manipulators.

In many exemplary embodiments of the system for robotic surgery, theprocessor includes non-transitory machine readable code embodyinginstructions for determining an input displacement of the first link ofthe first manipulator from a first position to a second positionrelative to the platform. The input displacement may be due to themanual movement of the first link. The non-transitory machine readablecode may also embody instructions for calculating the movement commandso as to effect a desired movement of the support structure using theinput displacement so that the orienting platform moves while manuallymoving the first link.

In other exemplary embodiments, the system further includes a manuallyarticulatable linkage disposed between the platform and the firstmanipulator. The processor, while in the platform movement mode, mayallow manual articulation of the manually articulatable linkage and mayinhibit articulation of the first manipulator. The processor may drivethe support structure so that the manipulator moves as a substantiallyrigid body and the platform follows the first link during the manualmovement of the first link.

In additional embodiments, the processor may be configured to calculatethe movement of the linkage using a velocity of the first link relativeto the orienting platform so that the driving of the linkage of theset-up structure reduces the relative velocity. The processor may befurther configured to calculate the movement command so that thevelocity of the first link relative to the orienting platform is reducedby a saturation velocity when the velocity of the first link relative tothe orienting platform exceeds the saturation threshold. In furtherembodiments, the processor may be configured to calculate the movementcommand so that the movement of the set-up structure is resilientlyurged away from a configuration when the velocity of the first linkrelative to the orienting platform moves the set-up structure toward anundesirable motion-limiting configuration of a set-up joint linkagebetween the manipulator and the orienting platform. The platformmovement mode may be entered in response to the set-up linkage structureapproaching or reaching the undesirable configuration.

In many embodiments, the system may include instrument holders coupledto each of the manipulators. The manipulators may be configured tosupport an associated surgical instrument mounted to the instrumentholder relative to a manipulator base. The manipulators may be furtherconfigured to insert the associated surgical instrument along aninsertion axis into a patient through an associated remote center ofmanipulation (RC). Additionally, the manipulators may be configured torotate the instrument holder around one or more axes that intersect theassociated RC. Also the axes may be transverse to the insertion axis.For example, a first and second manipulator axis may intersect theassociated RC, and each may be transverse to the insertion axis.Moreover the second manipulator axis may be transverse to the firstmanipulator axis.

In many embodiments of the system, the set-up structure linkage mayinclude a mounting base, a column, a member, and an extendable boom. Thecolumn may be slideably coupled with the mounting base. Additionally,the column may be selectively positioned relative to the mounting basealong a first support axis that is vertically oriented. The member maybe a boom base member rotationally coupled to the column through ashoulder joint. The member may be selectively oriented relative to thecolumn around a second support axis that is vertically oriented. Theextendable boom may be slideably coupled with the member to selectivelyposition the extendable boom relative to the member along a thirdsupport axis that is horizontally oriented. The orienting platform maybe rotationally coupled to the extendable boom member. In someembodiments, the first link is the instrument holder or is adjacentthereto. The calculated movement may include a movement of a pluralityof joints of the set-up structure linkage and the plurality of jointsmay be driven per the calculated movement so that the first link of thefirst manipulator has the preferred positional relationship relative tothe manipulator base.

In additional exemplary embodiments, the first manipulator of the systemmay include an orienting platform movement input mounted thereon oradjacent thereto. The movement input may normally be in a first stateand may be manually actuatable to a second state. When the movementinput is in the first state, the processor is configured to inhibitmovement of the orienting platform in response to movement of the firstlink. The system may further include a cannula mounted to the firstmanipulator and the processor may be configured to inhibit movement ofthe orienting platform during the mounting of the cannula. In manyexemplary embodiments, the support structure linkage may include aplurality of joints. The processor may be configured to inhibit movementalong each joint of the set-up structure linkage with an associatedjoint break in response to movement input being in the first state or inresponse to the mounting of the cannula to the first manipulator.

For a fuller understanding of the nature and advantages of the presentinvention, reference should be made to the ensuing detailed descriptionand accompanying drawings. Other aspects, objects and advantages of theinvention will be apparent from the drawings and detailed descriptionthat follows.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a plan view of a minimally invasive robotic surgery systembeing used to perform a surgery, in accordance with many embodiments.

FIG. 2 is a perspective view of a surgeon's control console for arobotic surgery system, in accordance with many embodiments.

FIG. 3 is a perspective view of a robotic surgery system electronicscart, in accordance with many embodiments.

FIG. 4 diagrammatically illustrates a robotic surgery system, inaccordance with many embodiments.

FIG. 5A is a partial view of a patient side cart (surgical robot) of arobotic surgery system, in accordance with many embodiments.

FIG. 5B is a front view of a robotic surgery tool, in accordance withmany embodiments.

FIG. 6 is a perspective schematic representation of a robotic surgerysystem, in accordance with many embodiments.

FIG. 7 is a perspective schematic representation of another roboticsurgery system, in accordance with many embodiments.

FIG. 8 shows a robotic surgery system, in accordance with manyembodiments, in conformance with the schematic representation of FIG. 7.

FIG. 9 illustrates rotational orientation limits of set-up linkagesrelative to an orienting platform of the robotic surgery system of FIG.8.

FIG. 10 shows a center of gravity diagram associated with a rotationallimit of the boom assembly for a robotic surgery system, in accordancewith many embodiments.

FIG. 11 is a flow chart schematically illustrating a method forpreparing a robotic surgical system for surgery by driving an orientingplatform in response to movement of a link of one of a plurality ofrobotic manipulator arms supported by the orienting platform.

FIG. 12 is a perspective schematic representation of movement of anorienting platform supported by a cart-mounted set-up support structureso as to provide a desired alignment of a plurality of manipulator armswith associated surgical access sites.

FIGS. 12A and 12B are block diagrams illustrating controllers used ascomponents of the orienting platform drive system, and particularlyshowing an exemplary software system arrangement of the processor.

FIGS. 12C and 12D are a schematic representation of an orientingplatform showing an associated coordinate system and degrees of freedom;and a perspective representation of an orienting platform supported by aceiling gantry set-up support structure so as to provide a desiredalignment of a single manipulator arm with an associated surgical accesssite.

FIG. 13 schematically shows a simplified four joint planarpassive/active robotic kinematic system in which active joints aredriven in response to deflection of passive joints.

FIG. 14 schematically shows a simplified three link planar joint systemfor use in describing kinematic analysis of the desired joint control.

FIG. 15 graphically shows movement of a simplified planar kinematicsystem through its null space so as to demonstrate driven motion of aset-up structure supporting a manually articulatable joint system inresponse to manual articulation of one or more of those joints.

DETAILED DESCRIPTION

In the following description, various embodiments of the presentinvention will be described. For purposes of explanation, specificconfigurations and details are set forth in order to provide a thoroughunderstanding of the embodiments. However, it will also be apparent toone skilled in the art that the present invention may be practicedwithout the specific details. Furthermore, well-known features may beomitted or simplified in order not to obscure the embodiment beingdescribed.

The kinematic linkage structures and control systems described hereinare particularly beneficial in helping system users to arrange therobotic structure of a procedure on a particular patient. Along withactively driven manipulators used to interact with tissues and the likeduring treatment, robotic surgical systems may have one or morekinematic linkage systems that are configured to support and help alignthe manipulator structure with the surgical work site. These set-upsystems may be actively driven or may be passive, so that they aremanually articulated and then locked into the desired configurationwhile the manipulator is used therapeutically. The passive set-upkinematic systems may have advantages in size, weight, complexity, andcost. Unfortunately, a plurality of manipulators may be used to treattissues of each patient, the manipulators may each independently benefitfrom accurate positioning so as to allow the instrument supported bythat instrument to have the desired motion throughout the workspace, andminor changes in the relative locations of adjacent manipulators mayhave significant impact on the interactions between manipulators (withpoorly positioned manipulators potentially colliding or having theirrange and/or ease of motion significantly reduced). Hence, thechallenges of quickly arranging the robotic system in preparation forsurgery can be significant.

One option is to mount multiple manipulators to a single platform, withthe manipulator-supporting platform sometimes being referred to as anorienting platform. The orienting platform can be supported by anactively driven support linkage (sometimes referred to herein as aset-up structure, and typically having a set-up structure linkage, etc.)The system may also provide and control motorized axes of the roboticset-up structure supporting the orienting platform with some kind ofjoystick or set of buttons that would allow the user to actively drivethose axes as desired in an independent fashion. This approach, whileuseful in some situations, may suffer from some disadvantages. Firstly,users not sufficiently familiar with robotics, kinematics, range ofmotion limitations and manipulator-to-manipulator collisions may find itdifficult to know where to position the orienting platform in order toachieve a good setup. Secondly, the presence of any passive jointswithin the system means that the positioning of the device involves acombination of manual adjustment (moving the passive degrees of freedomby hand) as well as controlling the active degrees of freedom, which canbe a difficult and time-consuming iterative activity.

To maintain the advantages of both manual and actively-drivenpositioning of the robotic manipulators, embodiments of the roboticsystems described herein may employ a set-up mode in which one or morejoints are actively driven in response to manual articulation of one ormore other joints of the kinematic chain. In many embodiments, theactively driven joints will move a platform-supporting linkage structurethat supports multiple manipulators, greatly facilitating thearrangement of the overall system by moving those manipulators as a unitinto an initial orientational and/or positional alignment with theworkspace. Independent positioning of one, some or all of themanipulators supported by the platform can optionally be providedthrough passive set-up joint systems supporting one, some, or all of themanipulators relative to the platform.

Minimally Invasive Robotic Surgery

Referring now to the drawings, in which like reference numeralsrepresent like parts throughout the several views, FIG. 1 is a plan viewillustration of a Minimally Invasive Robotic Surgical (MIRS) system 10,typically used for performing a minimally invasive diagnostic orsurgical procedure on a Patient 12 who is lying down on an Operatingtable 14. The system can include a Surgeon's Console 16 for use by aSurgeon 18 during the procedure. One or more Assistants 20 may alsoparticipate in the procedure. The MIRS system 10 can further include aPatient Side Cart 22 (surgical robot) and an Electronics Cart 24. ThePatient Side Cart 22 can manipulate at least one removably coupled toolassembly 26 (hereinafter simply referred to as a “tool”) through aminimally invasive incision in the body of the Patient 12 while theSurgeon 18 views the surgical site through the Console 16. An image ofthe surgical site can be obtained by an endoscope 28, such as astereoscopic endoscope, which can be manipulated by the Patient SideCart 22 to orient the endoscope 28. The Electronics Cart 24 can be usedto process the images of the surgical site for subsequent display to theSurgeon 18 through the Surgeon's Console 16. The number of surgicaltools 26 used at one time will generally depend on the diagnostic orsurgical procedure and the space constraints within the operating roomamong other factors. If it is necessary to change one or more of thetools 26 being used during a procedure, an Assistant 20 may remove thetool 26 from the Patient Side Cart 22, and replace it with another tool26 from a tray 30 in the operating room.

FIG. 2 is a perspective view of the Surgeon's Console 16. The Surgeon'sConsole 16 includes a left eye display 32 and a right eye display 34 forpresenting the Surgeon 18 with a coordinated stereo view of the surgicalsite that enables depth perception. The Console 16 further includes oneor more input control devices 36, which in turn cause the Patient SideCart 22 (shown in FIG. 1) to manipulate one or more tools. The inputcontrol devices 36 can provide the same degrees of freedom as theirassociated tools 26 (shown in FIG. 1) to provide the Surgeon withtelepresence, or the perception that the input control devices 36 areintegral with the tools 26 so that the Surgeon has a strong sense ofdirectly controlling the tools 26. To this end, position, force, andtactile feedback sensors (not shown) may be employed to transmitposition, force, and tactile sensations from the tools 26 back to theSurgeon's hands through the input control devices 36.

The Surgeon's Console 16 is usually located in the same room as thepatient so that the Surgeon may directly monitor the procedure, bephysically present if necessary, and speak to an Assistant directlyrather than over the telephone or other communication medium. However,the Surgeon can be located in a different room, a completely differentbuilding, or other remote location from the Patient allowing for remotesurgical procedures.

FIG. 3 is a perspective view of the Electronics Cart 24. The ElectronicsCart 24 can be coupled with the endoscope 28 and can include a processorto process captured images for subsequent display, such as to a Surgeonon the Surgeon's Console, or on another suitable display located locallyand/or remotely. For example, where a stereoscopic endoscope is used,the Electronics Cart 24 can process the captured images to present theSurgeon with coordinated stereo images of the surgical site. Suchcoordination can include alignment between the opposing images and caninclude adjusting the stereo working distance of the stereoscopicendoscope. As another example, image processing can include the use ofpreviously determined camera calibration parameters to compensate forimaging errors of the image capture device, such as optical aberrations.

FIG. 4 diagrammatically illustrates a robotic surgery system 50 (such asMIRS system 10 of FIG. 1). As discussed above, a Surgeon's Console 52(such as Surgeon's Console 16 in FIG. 1) can be used by a Surgeon tocontrol a Patient Side Cart (Surgical Robot) 54 (such as Patent SideCart 22 in FIG. 1) during a minimally invasive procedure. The PatientSide Cart 54 can use an imaging device, such as a stereoscopicendoscope, to capture images of the procedure site and output thecaptured images to an Electronics Cart 56 (such as the Electronics Cart24 in FIG. 1). As discussed above, the Electronics Cart 56 can processthe captured images in a variety of ways prior to any subsequentdisplay. For example, the Electronics Cart 56 can overlay the capturedimages with a virtual control interface prior to displaying the combinedimages to the Surgeon via the Surgeon's Console 52. The Patient SideCart 54 can output the captured images for processing outside theElectronics Cart 56. For example, the Patient Side Cart 54 can outputthe captured images to a processor 58, which can be used to process thecaptured images. The images can also be processed by a combination theElectronics Cart 56 and the processor 58, which can be coupled togetherto process the captured images jointly, sequentially, and/orcombinations thereof. One or more separate displays 60 can also becoupled with the processor 58 and/or the Electronics Cart 56 for localand/or remote display of images, such as images of the procedure site,or other related images.

Processor 58 will typically include a combination of hardware andsoftware, with the software comprising tangible media embodying computerreadable code instructions for performing the method steps of thecontrol functionally described herein. The hardware typically includesone or more data processing boards, which may be co-located but willoften have components distributed among the robotic structures describedherein. The software will often comprise a non-volatile media, and couldalso comprise a monolithic code but will more typically comprise anumber of subroutines, optionally running in any of a wide variety ofdistributed data processing architectures.

FIGS. 5A and 5B show a Patient Side Cart 22 and a surgical tool 62,respectively. The surgical tool 62 is an example of the surgical tools26. The Patient Side Cart 22 shown provides for the manipulation ofthree surgical tools 26 and an imaging device 28, such as a stereoscopicendoscope used for the capture of images of the site of the procedure.Manipulation is provided by robotic mechanisms having a number ofrobotic joints. The imaging device 28 and the surgical tools 26 can bepositioned and manipulated through incisions in the patient so that akinematic remote center is maintained at the incision to minimize thesize of the incision. Images of the surgical site can include images ofthe distal ends of the surgical tools 26 when they are positioned withinthe field-of-view of the imaging device 28.

Surgical tools 26 are inserted into the patient by inserting a tubularcannula 64 through a minimally invasive access aperture such as anincision, natural orifice, percutaneous penetration, or the like.Cannula 64 is mounted to the robotic manipulator arm and the shaft ofsurgical tool 26 passes through the lumen of the cannula. Themanipulator arm may transmit signals indicating that the cannula hasbeen mounted thereon.

Robotic Surgery Systems and Modular Manipulator Supports

FIG. 6 is a perspective schematic representation of a robotic surgerysystem 70, in accordance with many embodiments. The surgery system 70includes a mounting base 72, a support linkage 74, an orienting platform76, a plurality of outer set-up linkages 78 (two shown), a plurality ofinner set-up linkages 80 (two shown), and a plurality of surgicalinstrument manipulators 82. Each of the manipulators 82 is operable toselectively articulate a surgical instrument mounted to the manipulator82 and insertable into a patient along an insertion axis. Each of themanipulators 82 is attached to and supported by one of the set-uplinkages 78, 80. Each of the outer set-up linkages 78 is rotationallycoupled to and supported by the orienting platform 76 by a first set-uplinkage joint 84. Each of the inner set-up linkages 80 is fixedlyattached to and supported by the orienting platform 76. The orientingplatform 76 is rotationally coupled to and supported by the supportlinkage 74. And the support linkage 74 is fixedly attached to andsupported by the mounting base 72.

In many embodiments, the mounting base 72 is a movable and floorsupported, thereby enabling selective repositioning of the overallsurgery system 70, for example, within an operating room. The mountingbase 72 can include a steerable wheel assembly and/or any other suitablesupport features that provide for both selective repositioning as wellas selectively preventing movement of the mounting base 72 from aselected position. The mounting base 72 can also have other suitableconfigurations, for example, a ceiling mount, fixed floor/pedestalmount, a wall mount, or an interface configured for being supported byany other suitable mounting surface.

The support linkage 74 is operable to selectively position and/or orientthe orienting platform 76 relative to the mounting base 72. The supportlinkage 74 includes a column base 86, a translatable column member 88, ashoulder joint 90, a boom base member 92, a boom first stage member 94,a boom second stage member 96, and a wrist joint 98. The column base 86is fixedly attached to the mounting base 72. The translatable columnmember 88 is slideably coupled to the column base 86 for translationrelative to column base 86. In many embodiments, the translatable columnmember 88 translates relative to the column base 86 along a verticallyoriented axis. The boom base member 92 is rotationally coupled to thetranslatable column member 88 by the shoulder joint 90. The shoulderjoint 90 is operable to selectively orient the boom base member 92 in ahorizontal plane relative to the translatable column member 88, whichhas a fixed angular orientation relative to the column base 86 and themounting base 72. The boom first stage member 94 is selectivelytranslatable relative to the boom base member 92 in a horizontaldirection, which in many embodiments is aligned with both the boom basemember 92 and the boom first stage member 94. The boom second stagemember 96 is likewise selectively translatable relative to the boomfirst stage member 94 in a horizontal direction, which in manyembodiments is aligned with the boom first stage member 94 and the boomsecond stage member 96. Accordingly, the support linkage 74 is operableto selectively set the distance between the shoulder joint 90 and thedistal end of the boom second stage member 96. The wrist joint 98rotationally couples the distal end of the boom second stage member 96to the orienting platform 76. The wrist joint 98 is operable toselectively set the angular orientation of the orienting platform 76relative to the mounting base 72.

Each of the set-up linkages 78, 80 is operable to selectively positionand/or orient the associated manipulator 82 relative to the orientingplatform 76. Each of the set-up linkages 78, 80 includes a set-uplinkage base link 100, a set-up linkage extension link 102, a set-uplinkage parallelogram linkage portion 104, a set-up linkage verticallink 106, a second set-up linkage joint 108, and a manipulator supportlink 110. In each of the set-up linkage base links 100 of the outerset-up linkages 78 can be selectively oriented relative to the orientingplatform 76 via the operation of the a first set-up linkage joint 84. Inthe embodiment shown, each of the set-up linkage base links 100 of theinner set-up linkages 80 is fixedly attached to the orienting platform76. Each of the inner set-up linkages 80 can also be rotationallyattached to the orienting platform 76 similar to the outer set-uplinkages via an additional first set-up linkage joints 84. Each of theset-up linkage extension links 102 is translatable relative to theassociated set-up linkage base link 100 in a horizontal direction, whichin many embodiments is aligned with the associated set-up linkage baselink and the set-up linkage extension link 102. Each of the set-uplinkage parallelogram linkage portions 104 configured and operable toselectively translate the set-up linkage vertical link 106 in a verticaldirection while keeping the set-up linkage vertical link 106 verticallyoriented. In example embodiments, each of the set-up linkageparallelogram linkage portions 104 includes a first parallelogram joint112, a coupling link 114, and a second parallelogram 116. The firstparallelogram joint 112 rotationally couples the coupling link 114 tothe set-up linkage extension link 102. The second parallelogram joint116 rotationally couples the set-up linkage vertical link 106 to thecoupling link 114. The first parallelogram joint 112 is rotationallytied to the second parallelogram joint 116 such that rotation of thecoupling link 114 relative to the set-up linkage extension link 102 ismatched by a counteracting rotation of the set-up linkage vertical link106 relative to the coupling link 114 so as to maintain the set-uplinkage vertical link 106 vertically oriented while the set-up linkagevertical link 106 is selectively translated vertically. The secondset-up linkage joint 108 is operable to selectively orient themanipulator support link 110 relative to the set-up linkage verticallink 106, thereby selectively orienting the associated attachedmanipulator 82 relative to the set-up linkage vertical link 106.

FIG. 7 is a perspective schematic representation of a robotic surgerysystem 120, in accordance with many embodiments. Because the surgerysystem 120 includes components similar to components of the surgerysystem 70 of FIG. 6, the same reference numbers are used for similarcomponents and the corresponding description of the similar componentsset forth above is applicable to the surgery system 120 and is omittedhere to avoid repetition. The surgery system 120 includes the mountingbase 72, a support linkage 122, an orienting platform 124, a pluralityof set-up linkages 126 (four shown), and a plurality of the surgicalinstrument manipulators 82. Each of the manipulators 82 is operable toselectively articulate a surgical instrument mounted to the manipulator82 and insertable into a patient along an insertion axis. Each of themanipulators 82 is attached to and supported by one of the set-uplinkages 126. Each of the set-up linkages 126 is rotationally coupled toand supported by the orienting platform 124 by the first set-up linkagejoint 84. The orienting platform 124 is rotationally coupled to andsupported by the support linkage 122. And the support linkage 122 isfixedly attached to and supported by the mounting base 72.

The support linkage 122 is operable to selectively position and/ororient the orienting platform 124 relative to the mounting base 72. Thesupport linkage 122 includes the column base 86, the translatable columnmember 88, the shoulder joint 90, the boom base member 92, the boomfirst stage member 94, and the wrist joint 98. The support linkage 122is operable to selectively set the distance between the shoulder joint90 and the distal end of the boom first stage member 94. The wrist joint98 rotationally couples the distal end of the boom first stage member 94to the orienting platform 124. The wrist joint 98 is operable toselectively set the angular orientation of the orienting platform 124relative to the mounting base 72.

Each of the set-up linkages 126 is operable to selectively positionand/or orient the associated manipulator 82 relative to the orientingplatform 124. Each of the set-up linkages 126 includes the set-uplinkage base link 100, the set-up linkage extension link 102, the set-uplinkage vertical link 106, the second set-up linkage joint 108, atornado mechanism support link 128, and a tornado mechanism 130. Each ofthe set-up linkage base links 100 of the set-up linkages 126 can beselectively oriented relative to the orienting platform 124 via theoperation of the associated first set-up linkage joint 84. Each of theset-up linkage vertical links 106 is selectively translatable in avertical direction relative to the associated set-up linkage extensionlink 102. The second set-up linkage joint 108 is operable to selectivelyorient the tornado mechanism support link 128 relative to the set-uplinkage vertical link 106

Each of the tornado mechanisms 130 includes a tornado joint 132, acoupling link 134, and a manipulator support 136. The coupling link 134fixedly couples the manipulator support 136 to the tornado joint 132.The tornado joint 130 is operable to rotate the manipulator support 136relative to the tornado mechanism support link 128 around a tornado axis136. The tornado mechanism 128 is configured to position and orient themanipulator support 134 such that the remote center of manipulation (RC)of the manipulator 82 is intersected by the tornado axis 136.Accordingly, operation of the tornado joint 132 can be used to reorientthe associated manipulator 82 relative to the patient without moving theassociated remote center of manipulation (RC) relative to the patient.

FIG. 8 is a simplified representation of a robotic surgery system 140,in accordance with many embodiments, in conformance with the schematicrepresentation of the robotic surgery system 120 of FIG. 7. Because thesurgery system 140 conforms to the robotic surgery system 120 of FIG. 7,the same reference numbers are used for analogous components and thecorresponding description of the analogous components set forth above isapplicable to the surgery system 140 and is omitted here to avoidrepetition.

The support linkage 122 is configured to selectively position and orientthe orienting platform 124 relative to the mounting base 72 via relativemovement between links of the support linkage 122 along multiple set-upstructure axes. The translatable column member 88 is selectivelyrepositionable relative to the column base 86 along a first set-upstructure (SUS) axis 142, which is vertically oriented in manyembodiments. The shoulder joint 90 is operable to selectively orient theboom base member 92 relative to the translatable column member 88 arounda second SUS axis 144, which is vertically oriented in many embodiments.The boom first stage member 94 is selectively repositionable relative tothe boom base member 92 along a third SUS axis 146, which ishorizontally oriented in many embodiments. And the wrist joint 98 isoperable to selectively orient the orienting platform 124 relative tothe boom first stage member 94 around a fourth SUS axis 148, which isvertically oriented in many embodiments.

Each of the set-up linkages 126 is configured to selectively positionand orient the associated manipulator 82 relative to the orientingplatform 124 via relative movement between links of the set-up linkage126 along multiple set-up joint (SUJ) axes. Each of the first set-uplinkage joint 84 is operable to selectively orient the associated set-uplinkage base link 100 relative to the orienting platform 124 around afirst SUJ axis 150, which in many embodiments is vertically oriented.Each of the set-up linkage extension links 102 can be selectivelyrepositioned relative to the associated set-up linkage base link 10along a second SUJ axis 152, which is horizontally oriented in manyembodiments. Each of the set-up linkage vertical links 106 can beselectively repositioned relative to the associated set-up linkageextension link 102 along a third SUJ axis 154, which is verticallyoriented in many embodiments. Each of the second set-up linkage joints108 is operable to selectively orient the tornado mechanism support link128 relative to the set-up linkage vertical link 106 around the thirdSUJ axis 154. Each of the tornado joints 132 is operable to rotate theassociated manipulator 82 around the associated tornado axis 138.

FIG. 9 illustrates rotational orientation limits of the set-up linkages126 relative to the orienting platform 124, in accordance with manyembodiments. Each of the set-up linkages 126 is shown in a clockwiselimit orientation relative to the orienting platform 124. Acorresponding counter-clockwise limit orientation is represented by amirror image of FIG. 9 relative to a vertically-oriented mirror plane.As illustrated, each of the two inner set-up linkages 126 can beoriented from 5 degrees from a vertical reference 156 in one directionto 75 degrees from the vertical reference 156 in the opposite direction.And as illustrated, each of the two outer set-up linkages can beoriented from 15 degrees to 95 degrees from the vertical reference 156in a corresponding direction.

FIG. 10 shows a center of gravity diagram associated with a rotationallimit of a support linkage for a robotic surgery system 160, inaccordance with many embodiments. With components of the robotic surgerysystem 160 positioned and oriented to shift the center-of-gravity 162 ofthe robotic surgery system 160 to a maximum extent to one side relativeto a support linkage 164 of the surgery system 160, a shoulder joint ofthe support linkage 164 can be configured to limit rotation of thesupport structure 164 around a set-up structure (SUS) shoulder-jointaxis 166 to prevent exceeding a predetermined stability limit of themounting base.

Positioning of the Orienting Platform in Response to Manual Articulationof One or More Joints of the Kinematic Chain Supported by the OrientingPlatform

FIGS. 11 and 12 schematically illustrate a method for driving theorienting platform in response to movement of a link 170 of amanipulator 82 during set-up of the robotic system for use. In exemplaryembodiments, the reference location for movement may not be located onlink 170, but may instead be offset relative to link 170. For example,the reference location for movement may be disposed at a remote centerlocation offset from a base (or other structure) of a manipulatorlinkage, particularly where that manipulator mechanically constrainsmotion of the manipulator to spherical motion at a fixed remote centerlocation relative to that base. Hence, while the base (or other linkagestructure) of the manipulator may serve as an input link 170, thereference location may be spatially separated from the link itself,often at a fixed location in the frame of reference of the link.

Prior to driving of the orienting platform, the platform will have aninitial position and orientation relative to mounting base 72 (dependingon the states of the joints of the support linkage 70), and themanipulators will each have an associated location and orientationrelative to the orienting platform (depending on the states of thejoints of the set-up linkages 78, 80). Similarly, a link 170 of each ofthe manipulators 82 (and/or a reference location associated with thatlink) will have a position and orientation relative to the platform 76which depends on the state of the joints of the manipulator between themanipulator base (schematically illustrated here by the boxes M) and theplatform 76. Link 170 will typically comprise a base of the manipulator,but may alternatively comprise a link kinematically near or adjacent thesurgical instrument, such as the instrument holder or carriage. Thejoint states of the manipulator can generally be described by a posevector θ.

During set-up, it will often be desirable to move one, some, or all ofthe links 170 from their initial positions and orientations to desiredposition(s) and orientation(s) aligned with a surgical site.Additionally, it will often be desirable to start a surgical procedurewith the manipulators in a well-conditioned state so as to provide thesurgeon with a wide range of motion, help avoid singularities, and thelike. In other words, for a given manipulator it will be beneficial toprovide both a desired alignment between link 170 and the surgicalworksite (including having the remote center RC of the manipulator at ornear a desired access site location RC_(D)), and to have the manipulatorat or near a desired manipulator state or pose θ_(D). Note that themanipulator may already be at or near the desired manipulator pose priorto movement of link 170, or that may be in an initial pose θ_(I)significantly different than the desired, well-conditioned pose(θ_(I≠)θ_(D)). Appropriate positioning and configuring of themanipulators relative to each other may also help avoid manipulatorcollisions. Where the manipulator is not in a well-conditioned poseprior to alignment with the surgical site, the pose of the manipulatormay optionally be altered to a well-conditioned pose before moving theorienting platform, after moving the orienting platform, or while movingthe orienting platform. Altering the pose from the initial pose to thewell-conditioned pose may be done by manually articulating the joints ofthe manipulator. Alternatively, there may be advantages to driving themanipulator from the initial pose toward and/or to the well-conditionedpose. For simplicity, the description below assumes the manipulators arein a desired and/or well-conditioned pose prior to initiation ofmovement of the platform. Regardless, mounting of multiple manipulators82 to a common platform 76 and driven movement of that platform inresponse to movement of a link of one of the joints supporting one ofthe manipulators relative to the platform can facilitate movement of themanipulators into the desired alignment with the surgical space.

The joints of the manipulator will often be maintained in a fixedconfiguration during movement of the orienting platform and/or manualarticulation of the set-up linkages, optionally by driving the motors ofeach of the joints of the manipulator so as to counteract any manualarticulation, by fixing the joint states of the manipulators with jointbrakes, by a combination of both, or the like. Hence, while there may besome slight flexing of the links and minor excursions of the jointsduring movement of the orienting platform and manual articulation of theset-up linkages, the manipulators will typically move as a substantiallyrigid body. Moreover, the link 170 manipulated by the user and/or to beused as a reference for movement may be any one or more link of (or evenkinematically adjacent to) the manipulator.

Referring now to FIGS. 11 and 12, to enter the orienting platform movingmode 180 of the robotic system processor, an input 172 on or adjacent anassociated link 170 may be activated. While Input 172 may optionallycomprise a simple dedicated input button or the like, some embodimentsmay benefit from alternative user interface approaches. As an example,an exemplary input may avoid a dedicated button by instead entering theplatform moving mode in response to a set-up joint operation. Morespecifically, the platform moving mode may be entered by first releasingthe set-up joints supporting an associate manipulator so as to allow theremote center (or “port”) location of that manipulator to be manuallyrepositioned, a manual movement mode which is sometimes referred to asport clutching. When the manipulator is manually moved to within athreshold of (or in some embodiments actually reaches) a range of motionlimit for the released set-up joint linkage, the system may in responseenter the platform following mode. Hence, reaching (or approaching) therange of motion limit of the set-up joints becomes a method to requestand/or input activation for the entering of the platform movement mode.Input 172 may alternatively be a simple normally off input.

The processor may not enter the orienting platform moving mode despiteactuation of the input if a cannula is mounted to the manipulator (or toany other manipulator supported by the orienting platform). While input172 of a given manipulator 82 is actuated, and/or in response toactuation of input 172, the set-up linkages 78, 80 disposed between thatmanipulator and the orienting platform will often be unlocked so as toallow manual articulation. This articulation of set-up linkages 78, 80can be sensed and used as an input for driving the joints of the set-upstructure for moving the orienting platform 76. The system will often bebalanced about the axes of the set-up linkages so that the user caneasily re-orient and/or re-position the manipulator relative to theoperating platform in platform, with the manipulator typically moving asa relatively rigid when link 172 is moved relative to the platform andthe base 72 of the system. Note that the drive system of the manipulatormay be energized and controlled by the processor so as to resistarticulation of the joints of the manipulator displacement, or thatjoint brakes of the manipulator may inhibit articulation, but that someflexing of the manipulator linkages and/or minor excursions of thejoints states may still result from the forces imposed on link 172. Notealso that in alternative embodiments the joints that are allowed toarticulate between link 172 and the orienting platform are powered (suchas in a software-center system) those joints may be energized to as toprovide movement resistance forces that are sufficiently light so as toallow the link to be manually moved sufficiently for the joint statesensing system of the manipulator to readily identify the desireddisplacement vector for use as a desired movement input or command fromthe system user.

Referring still to FIGS. 11 and 12 and as generally noted above, oncethe orienting platform moving mode has been entered with a particularmanipulator 82 to be used as the input device (such as by depressing aswitch of input 172), link 170 of that manipulator can be manually movedrelative to the platform. Typically, one or more (optionally all) of theset-up joints may be released so as to allow the input movement of link170 to occur via manual articulation of the released set-up joint(s),optionally while articulation of the linkage of the manipulator isinhibited (such as by driving the manipulator to avoid movement, using abrake system of the manipulator, or the like). Hence, the input may besensed at least in part as an articulation of one or more joints of theset-up joint system. Still further options may be employed, such asallowing the manual input via a selective combination of articulation ofone or more joints of the manipulator and one or more joints of theset-up joint system. Regardless, to facilitate kinematic analysis,provide input for helpful transformations, and the like, the jointstates of the set-up structure (including the joints supporting theorienting platform), the set-up joint system, and the manipulator willtypically be sensed 182.

Based on the manual input command by the user (as entered by manualmovement of link 170 and as sensed via the manual articulation of thejoints supporting that link), commands are calculated to move the set-upstructure 183. The orienting platform will often be driven per thecalculated commands while the user continues to move link 170, so thatthe base of the manipulators supported by the orienting platform followthe manually moving link. While moving a first manipulator into adesired alignment with the surgical site, the other manipulators mayeach remain in a fixed pose. Similarly, any set-up linkages between theorienting platform and those other manipulators may also remain locked(and/or otherwise have their articulation inhibited) during movement ofthe platform. As articulation may be inhibited for all the jointsbetween the links 170 of the other manipulators and the orientingplatform, all those other input links (and other structures of themanipulators) follow link 170 of the manipulator for which input 172 isactuated.

The orienting platform may be driven so that the input set-up linkagessupporting the input manipulator (for which input 172 is actuated),while the user holds and moves the associated link 170 to a desiredalignment with the workspace, are urged to remain in their initialconfiguration (as per when the system entered the orienting platformmode). The position of the link 170 may continue to be controlledmanually by the user during the movement of the orienting platform. Inother words, the orienting platform can be moved so that given a currentpose θ of the set-up linkages 78, 80 and a current location of the inputlink 170 (both during movement of the orienting platform), the drivesystem of the orienting platform moves the orienting platform 185 sothat the input set-up linkages 78, 80 are articulated from the currentpose toward their initial pose (θ→θi). The effect of this movement ofthe orienting platform is to largely maintain the initial specialrelationship between the input link 170 and the orienting platform, sothat the orienting platform (and all the manipulators supported thereby)follows the input link as it is moved by the hand of the user. Theorienting platform movement mode can be terminated 184 by releasinginput 172, by mounting a cannula to the input manipulator, or the like.Note that the cannula may not be mounted to the manipulator until afterthe cannula extends into the patient body, so that it may be desirablefor the processor system to inhibit entering of the orienting platformmovement mode in response to actuation of input 172 of a manipulator towhich the cannula is mounted.

Orienting platform 76 may support manipulators 80, 82 in beneficialrelative positions for many procedures. Hence, once a link 170 of afirst manipulator 80 has been moved to a desired alignment with asurgical worksite, the instrument holders and the like of the othermanipulators will often be at or near associated desired initialalignment for their associated surgical tools, and only limitedadditional re-positioning of the manipulators may be warranted. Minoradjustments to a particular manipulator alignment may be accommodated byreleasing a brake system of the set-up joint arm supporting thatmanipulator relative to the orienting platform and moving thatmanipulator as desired relative to all the other manipulators. Forexample, once a camera manipulator is used to position the orientingplatform and to initially align all the instrument manipulators, theset-up linkages between each instrument manipulator and the orientingplatform can be released and the released manipulator position can beadjusted independently if needed. In an exemplary embodiment oforienting platform movement mode, sensing of the manual movement of afirst input link 170 effectively senses movement of the manipulator froman initial remote center RC to a desired remote center RCd. Movement ofthe orienting platform moves the remote centers RC of the othermanipulators toward their associated desired remote centers RCd.Additional adjustment of those other remote center locations can then beperformed by sequentially releasing each of the set-up linkages of theassociated manipulator and moving the released manipulator so as toprovide the desired alignment between the released manipulator RC andthe desired remote center RCd.

Calculation of the Orienting Platform Movement Commands

Referring now to FIGS. 12A and 12B, an exemplary software structureand/or processor arrangement for calculating the movement commands ofthe orienting platform can be understood. As the orienting platform andother manipulators will often follow the movement of the input link 170for which the orienting movement input 172 has been actuated, theoverall movement is somewhat analogous to (and is sometimes referred toherein as) a “Lead-the-Horse-By-the-Nose” (LHBN) control mode. The LHBNcontrol mode allows the user to move the operating platform 76 and drivethe setup-structure by manually moving the remote center of a floatingmanipulator 82. In a basic form, the control objective is to move theoperating platform 76 such that the manipulator 82 remote-center remainsat a desired location in the operating platform 76 frame. Thus, when theuser manually displaces the manipulator 82 in the world frame, thecontroller can move the operating platform 76 and its frame through thesame displacement to drive the error between the actual remote centerand the desired remote center to zero.

The raw error between the actual remote center RC and desired remotecenter RCd locations form the input command 220 to the LHBN controller,as shown in FIG. 12A. A small dead zone 222 (less than 10 cm, oftenabout 3 cm or less) is applied to the error signal before scaling theerror into a raw velocity command. A low-pass filter (of between about0.1 Hz and 10 Hz, typically approximately 1 Hz) generates a band-limitedvelocity command. The command is then saturated 224 to create thevelocity command in the operating platform frame. When LHBN mode isentered a half cosine shaped scaling is applied to the command over ashort window to ramp up the command in a smooth manner. Similarly, thecommand is scaled by a half cosine shaped scaling in the reversedirection when the mode is exited to smooth the deceleration. Thevelocity command, after startup/shutdown scaling, is provided to thesetup structure's inverse kinematics. Further trimming of the velocitycommand may occur in the inverse kinematics calculations when joints areat or near (within a few their limits.

The desired remote center location RCd, also referred to herein as theanchor, is established when LHBN control mode is entered. When the LHBNcontrol mode is initiated, the desired remote center RCd and actualremote center RC are co-located, thus starting the mode with zero error(so that the platform will not move unless and until the input link 170moves relative to the orienting platform). Manual movement of the link170 while in the LHBN control mode causes the platform to be driven sothat the actual remote center RC generally remains at the desired remotecenter RCd in the frame of the operating platform. Several enhancementsto the basic LHBN operation may optionally slide or alter the locationof the anchor or desired remote center RCd relative to the actual remotecenter to tweak the behavior. The anchor can, for example, be moved bycommanding an anchor dragging velocity and integrating as indicated inFIG. 12A. One anchor velocity input may be the difference between thesaturated and unsaturated velocity command 226. The purpose of thisfeature may be to avoid large saturated velocity commands. Once thevelocity command reaches saturation, any additional input motion of theremote center drags the anchor (or moves the RCd relative to theorienting platform) to keep the command just at the saturation limit.Intuitively, the error between the anchor and the remote center can bevisualized as a ball, and dragging the anchor means dragging the ball'scenter around whenever the error vector reaches the ball's radius.

Motion away from range of motion limitations or hard stops of set-uplinkages 78, 80 is also achieved through anchor dragging, as can beunderstood with reference to the block diagram model shown in FIG. 12B.Some automatic motion of the set-up structure 74 away from hard-stops isdesirable as the user may not otherwise be able to easily manuallycommand the desired set-up structure motion. In one embodiment, asubroutine may compute a virtual force 230 acting on the platform 76that mimics springs installed at the limits of motion of the set-uplinkages 78, 80. The force can be referred to as a port-dragging force.A virtual force may be transmitted from each configured manipulator 82to enable the setup structure controller to back away from setup jointrange of motion limits. The LHBN control mode software can scale theport-dragging virtual force from the input manipulator 82 and add thisquantity to the anchor dragging velocity. The effect is to create acommand 232 to drive the set-up structure 76 to move away from hardstopsof set-up linkages 78, 80.

Some or all of the gains, saturations, and/or deadzones used in the LHBNcontrol mode are optionally tunable. Each parameter in FIGS. 12A and 12Bis listed in the Table below:

XY_DEADZONE, Deadzone applied to input motion in the x-y planeZ_DEADZONE, Deadzone applied to input motion in the z direction ERR_SAT,Maximum error input. Error beyond this value is saturated VFORCE_GAIN,Scaling of virtual forces from setup joints into anchor draggingvelocity VFORCE_MAXVEL, Saturation of anchor dragging velocitySHAPING_COEFF, Coefficients of the polynomial that shapes the saturatedposition command GAIN, Gain from position command (error signal postdeadzone and saturation) and the LBHN velocity command MAX_XY, Maximumvelocity command in the xy plane MAX_Z, Maximum velocity command in thez direction VELCMD, Final velocity command VSPRING_DZ_FRAC, Deadzonefraction of each setup joint range of motion VSPRING_GAIN, Gain fromposition to virtual joint force outside the deadzone of each jointRED_SUJ_JT_INV, Inverse transpose of the setup joint Jacobian.VSPRINT_FORCE, Final virtual force reflected to the OP

The virtual spring force used to move the set-up structure linkage awayfrom set-up joint linkage hard stops can be calculated as shown in FIG.12B, and the deadzone fraction may determine how much of the range ofmotion produces no virtual force. Note that the deadzone fraction shouldbe less than unity and that the active portion may be split evenlybetween the two hardstops on each joint. If the user moves the remotecenter such that a setup joint is against a hard-stop, anchor draggingcan be used to integrate the virtual force and increase the velocitycommand to move away from the hard-stop. A smoothly increasing velocitycommand will be generated that moves the setup structure away from thefrom the setup joint range of motion limit. The velocity command willincrease until saturation is reached at which point a steady-statevelocity of the setup structure will be maintained.

Thus a large gain on the virtual force will drive the errorsignificantly into saturation. For more description of the kernel keysinvolved in the calculation of the virtual force, see the Table above.

Referring now to FIG. 12C, an alternative drive system for the set-upstructure and orienting platform 124 preferably allows movement along x,y, and z axes to drive a manipulator RC to a desired position relativeto the orienting platform. By manually moving one or more link of amanipulator 82 in space (and optionally by moving the entiremanipulator), the user can cause the operating platform to follow byjust computing the error vector between the desired manipulator RCposition (in the orienting platform frame of reference) to the actualmanipulator RC position and using this vector to generate desired x, y,z velocities.

Referring now to FIGS. 12C and 12D, methods for moving the x, y, z, andθ axes of the orienting platform will generally seek to achieve adesired positioning of the orienting platform 124 and one or moremanipulators 82 mounted thereon so as to provide a well-conditionedmanipulator pose when starting a surgical procedure (with the variousdegrees of the freedom of the manipulator being desirably near theircenters of range of motions while the tool is in a desired location ofthe surgical workspace, with the manipulator kinematics being well awayfrom motion-inhibiting singularities, and the like). Along withorienting platforms supported by cart-mounted set-up structures such asthose described above, ceiling mounted set-up structures 190 and otherdriven robotic linkages with one, two, three, four, or more degrees offreedom may be employed. Similarly, the input for motion may optionallybe input by manually articulating a passive joint (such as one of thejoints along the set-up joint structure described above) and/or one ormore actively driven joints (such as a joint of the manipulator 80, 82).Hence, while the systems may be described with reference to a fewexemplary robotic kinematic structures, the control techniques may applywell to a range of other robotic systems having redundant degrees offreedom and/or large numbers of joints, and are particularly interestingwhen considering such systems that have a mix of active and passivejoints; systems with one set of joints that are driven during set-up andanother different set (with or without some overlapping members) ofjoints that are driven during surgery; systems in which individualmanipulator controllers exchange only limited state information; and thelike.

To use the robotic capabilities of the system during set-up, theprocessor of the robotic system may include software implementing a modein which the robotic structure is driven toward and/or maintains adesired relationship or pose between the orienting platform and themanipulator remote center during manual movement of a link of themanipulator. This algorithm, when active, takes as its inputs the actualand desired relationships between the orienting platform and themanipulator remote center and drives the actual pose to the desired one,optionally without disturbing the position and orientation of themanipulator remote center. In other words, as the user moves the passiveaxes around, the active axes may optionally follow in such a way so asto achieve or maintain a specific robot pose.

The simplified 4-link manipulator shown in FIG. 13 helps to explain oneembodiment of the control structures and methods described herein. Inthis schematic manipulator, links 191 and 192 are active, meaning thatq₁ and q₂ are controlled by a controller, while links 193 and 194 arepassive, and can be moved by hand. Point Q is a point on the robot ofdirect interest to the user, and is positioned manually to auser-specified target location relative to the robot base. Hence, pointQ may correspond to the remote center of the manipulator, and the userwould typically position point Q so that the manipulator could, forexample, be connected to the camera cannula, which may already beinstalled in the patient or which may be inserted in the patient afterthe robotic structure is moved into position. For various reasons(including maximizing usable range of motion, minimizing collisions,etc.) it is often desirable to obtain a specific relationship between Pand Q. As long as joints q₃ and q₄ are free, and there is sufficientrange of motion and the manipulator is not near a singularity, P cantranslate independently of Q, so the controller is free to establish thedesired relationship if Q is simply held fixed relative to the base.This principle can be taken advantage of to automatically establish theP to Q relationship while the user holds Q fixed in space. It is alsopossible to continuously run this automatic positioning algorithm, sothat as a user manually adjusts the position of Q, the active axes q₁and q₂ move in such a way so as to maintain the desired P-Qrelationship.

In the simplified example of FIG. 13, two active and two passive degreesof freedom are shown, and the only quantities of interest were therelative positions in the plane of P and Q. Ceiling and/or cart mountedrobotic surgical systems will often be more complex: there are sevenactive degrees of freedom (four on the gantry and three relevant axes onthe ECM) in the embodiment of FIG. 12D, and three passive axes(schematically shown by the set-up joints 198 between the orientingplatform 124 and the manipulator 82), for a total of ten degrees offreedom. Maintaining the manipulator remote center end point locationand orientation is often a six DOF issue, which leaves us with fourextra degrees of freedom (DOFs) with which to perform our internaloptimizations in this embodiment. Note that for purposes of thisdiscussion, the exact nature of what is considered desired may includeany number of criteria, and many concept described here can be appliedregardless of the method used to determine the optimal target location.One strategy for performing this sort of optimization is to consider theentire system as a single 10 DOF redundant manipulator. One can then usea technique of imposing a primary, inviolable goal paired with a desiredauxiliary goal of minimizing a cost function. The primary goal in ourcase may be to maintain the position and orientation of the manipulatorremote center relative to the room and the auxiliary goal may be toachieve the optimal relationship between the orienting platform and themanipulator.

A second strategy is to segment the problem into two parts:

1) A set-up structure optimization problem that seeks to minimize a costfunction. This cost function is configured to achieve a minimum when theorienting platform position and orientation reaches an optimal ordesired location relative to the manipulator RC.

2) A manipulator regulation problem that seeks to maintain a constantmanipulator orientation relative to the room.

This second strategy benefits from the fact that the only informationthat needs to be shared between the ECM and Gantry manipulator is thelocation of the base and tip of each—it is not required to know theposition of every joint. This lends this particular strategy a niceadvantage in that it requires less communication bandwidth betweenmanipulators.

We now provide the mathematical framework necessary to move the setupstructure without moving the remote center. Referring now to FIGS. 14and 15, reconfiguring a simplified planar set-up structure linkage to adesired pose may be modeled as moving the manipulator through its nullspace (per the description above of FIG. 13, so that Q remains invarientwhile P is driven to a desired x and y location in space).Mathematically, where the lengths of links 1-3 FIG. 14 are are l₁₋₃, theJacobian matrix and joint position vector q can be identified as:

x = l₁c₁ + l₂c₁₂ + l₃c₁₂₃ y = l₁c₁ + l₂c₁₂ + l₃c₁₂₃$J = \begin{bmatrix}{{- s_{1}} - s_{12} - s_{123}} & {{- s_{12}} - s_{123} - s_{123}} \\{c_{1} + c_{12} + c_{123}} & {c_{12} + {c_{123}c_{123}}}\end{bmatrix}$ ${q = \begin{bmatrix}\theta_{1} \\\theta_{2} \\\theta_{3}\end{bmatrix}},$

The following is a decomposition of the joint velocities as a sum ofend-effector motion and internal joint motions that result in noend-effector motion.

$\overset{o}{q} = {\underset{\underset{{Desired}{Cartesian}{motion}}{}}{J^{t}\overset{\rightharpoonup}{v}} + \underset{\underset{{{Desired}\mspace{14mu} {internal}}{{motion}\mspace{14mu} {through}\mspace{14mu} {Null}}{{Space}\mspace{14mu} {of}\mspace{14mu} {manipulator}}}{}}{\left( {I - {J^{t}J}} \right){\overset{o}{\overset{\rightharpoonup}{q}}}_{0}}}$${{{Set}\mspace{14mu} \overset{\rightharpoonup}{v}} = {\lbrack o\rbrack->{meaning}}},{{we}\mspace{14mu} {do}\mspace{14mu} {not}\mspace{14mu} {want}\mspace{14mu} {end}\mspace{14mu} {effector}\mspace{14mu} {to}\mspace{14mu} {move}}$${{Set}\mspace{14mu} {\overset{o}{\overset{\rightharpoonup}{q}}}_{0}} = {\begin{bmatrix}\overset{\overset{\rightharpoonup}{o}}{q_{\theta_{1}}} \\0 \\0\end{bmatrix}->\begin{matrix}{{meaning}\text{:}\mspace{11mu} {move}\mspace{14mu} \theta_{1}\mspace{14mu} {at}\mspace{14mu} {velocity}\mspace{14mu} {\overset{\overset{\rightharpoonup}{o}}{q_{\theta_{1}}}.}} \\{{{{Don}'}t\mspace{14mu} {care}\mspace{14mu} {what}\mspace{14mu} \theta_{2}\mspace{14mu} {and}\mspace{14mu} \theta_{3}\mspace{14mu} {do}},{{as}\mspace{14mu} {long}\mspace{14mu} {as}\mspace{14mu} {these}}} \\{{internal}\mspace{14mu} {motions}\mspace{14mu} {do}\mspace{14mu} {not}\mspace{14mu} {move}\mspace{14mu} {end}\mspace{14mu} {effector}}\end{matrix}}$

Hence, we can move θ₁ and did not have to specify θ₂ and θ₃ to move themanipulator through the null space without changing end effectorposition. Similarly from a Matlab simulation, we see that we can move anaxis through the Null space without having to specify the other joints.While the proceeding demonstrates optimization of planar set-up joints,the framework extends to orientation.

Other variations are within the spirit of the present invention. Thus,while the invention is susceptible to various modifications andalternative constructions, certain illustrated embodiments thereof areshown in the drawings and have been described above in detail. It shouldbe understood, however, that there is no intention to limit theinvention to the specific form or forms disclosed, but on the contrary,the intention is to cover all modifications, alternative constructions,and equivalents falling within the spirit and scope of the invention, asdefined in the appended claims.

The use of the terms “a” and “an” and “the” and similar referents in thecontext of describing the invention (especially in the context of thefollowing claims) are to be construed to cover both the singular and theplural, unless otherwise indicated herein or clearly contradicted bycontext. The terms “comprising,” “having,” “including,” and “containing”are to be construed as open-ended terms (i.e., meaning “including, butnot limited to,”) unless otherwise noted. The term “connected” is to beconstrued as partly or wholly contained within, attached to, or joinedtogether, even if there is something intervening. Recitation of rangesof values herein are merely intended to serve as a shorthand method ofreferring individually to each separate value falling within the range,unless otherwise indicated herein, and each separate value isincorporated into the specification as if it were individually recitedherein. All methods described herein can be performed in any suitableorder unless otherwise indicated herein or otherwise clearlycontradicted by context. The use of any and all examples, or exemplarylanguage (e.g., “such as”) provided herein, is intended merely to betterilluminate embodiments of the invention and does not pose a limitationon the scope of the invention unless otherwise claimed. No language inthe specification should be construed as indicating any non-claimedelement as essential to the practice of the invention.

Preferred embodiments of this invention are described herein, includingthe best mode known to the inventors for carrying out the invention.Variations of those preferred embodiments may become apparent to thoseof ordinary skill in the art upon reading the foregoing description. Theinventors expect skilled artisans to employ such variations asappropriate, and the inventors intend for the invention to be practicedotherwise than as specifically described herein. Accordingly, thisinvention includes all modifications and equivalents of the subjectmatter recited in the claims appended hereto as permitted by applicablelaw. Moreover, any combination of the above-described elements in allpossible variations thereof is encompassed by the invention unlessotherwise indicated herein or otherwise clearly contradicted by context.

All references, including publications, patent applications, andpatents, cited herein are hereby incorporated by reference to the sameextent as if each reference were individually and specifically indicatedto be incorporated by reference and were set forth in its entiretyherein.

What is claimed is:
 1. A method for preparing for robotic surgery, themethod comprising: sensing an input displacement of a first link of afirst robotic manipulator from an initial positional relationshiprelative to an orienting platform to a displaced positional relationshiprelative to the orienting platform, the input displacement resultingfrom a manual articulation of a set-up joint linkage supporting thefirst manipulator so that the first link moves toward a desiredalignment with a surgical site; calculating a movement of a set-upstructure linkage in response to the input displacement so that thefirst link of the first manipulator returns toward the initialpositional relationship relative to orienting platform, the set-upstructure linkage supporting the orienting platform and the orientingplatform supporting the first manipulator via the set-up joint linkageand a second manipulator; driving the set-up structure linkage per thecalculated movement.
 2. The method of claim 1, further comprisingmaintaining a fixed pose of the first manipulator during the inputdisplacement so that the first manipulator moves as a substantiallysolid body.
 3. The method of claim 2, wherein the set-up structure isdriven while a user manually moves the first link toward the desiredalignment with the surgical site.
 4. The method of claim 1, wherein thefirst link has a preferred positional relationship relative to theorienting platform prior to the manual movement, the calculated movementof the set-up structure linkage moving the orienting platform so as toreturn toward the preferred positional relationship during the manualmovement.
 5. The method of claim 4, wherein the preferred positionalrelationship helps maintain a desired range of motion of the firstmanipulator relative to the orienting platform.
 6. The method of claim1, wherein the movement of the set-up structure linkage is calculatedusing a velocity of the first link relative to the orienting platformduring the input displacement, and wherein the driving of the set-upstructure linkage diminishes the velocity.
 7. The method of claim 6,wherein the velocity of the first link relative to the orientingplatform exceeds a saturation threshold, and wherein the driving of theset up structure reduces the velocity of the first link relative to theorienting platform by the saturation threshold.
 8. The method of claim6, wherein the velocity of the first link relative to the orientingplatform moves the set-up structure toward an undesirablemotion-limiting configuration of a set-up joint linkage between themanipulator and the orienting platform, and wherein the movement of theset up structure is calculated so as to resiliently urge the set-upstructure away from the undesirable configuration.
 9. The method ofclaim 8, wherein the driving of the setup structure occurs in a platformmovement mode and wherein the platform movement mode is entered inresponse to the set-up linkage structure approaching or reaching theundesirable configuration.
 10. The method of claim 1, wherein each ofthe manipulators includes an instrument holder and is configured tosupport an associated surgical instrument mounted to the instrumentholder relative to a manipulator base, insert the associated surgicalinstrument along an insertion axis into a patient through an associatedremote center of manipulation (RC), rotate the instrument holder arounda first manipulator axis that intersects the associated RC, and rotatethe instrument holder around a second manipulator axis that intersectsthe associated RC, each of the first and second manipulator axes beingtransverse to the insertion axis, the second manipulator axis beingtransverse to the first manipulator axis; wherein the set-up structurelinkage comprises: a mounting base; a column selectively positionablerelative to the mounting base along a first support axis that isvertically oriented; a member rotationally coupled to the column toselectively orient the member relative to the column around a secondsupport axis that is vertically oriented; an extendable boom slideablycoupled with the member to selectively position the extendable boomrelative to the member along a third support axis that is horizontallyoriented, the orienting platform being rotationally coupled to theextendable boom member; and wherein the first link comprises or isadjacent the holder, wherein the calculated movement comprises amovement of a plurality of joints of the set-up structure linkage, andwherein the plurality of joints are driven per the calculated movementso that the first manipulator is well-conditioned.
 11. The method ofclaim 10, wherein the manual movement comprises aligning the associatedfirst RC of the first manipulator with a desired first RC of thesurgical site, and wherein the driven movement of the set-up structurelinkage moves the associated RC of the second manipulator toward an asecond desired RC of the surgical site.
 12. The method of claim 1,wherein the manipulator has an orienting platform movement input mountedadjacent the first link, the movement input normally in a first stateand manually actuatable to a second state, and wherein the orientingplatform does not move in response to movement of the first link whenthe movement input is in the first state.
 13. The method of claim 12,further comprising mounting a cannula to the first manipulator after themanual movement and inhibiting movement of the orienting platform inresponse to the mounting of the cannula, wherein the cannula isconfigured to provide access therethrough to an internal surgical sitefor a surgical instrument supported by the first manipulator.
 14. Themethod of claim 13, further comprising inhibiting movement along jointsof the set-up structure linkage with associated joint brakes in responseto the movement input being in the first state or in response to thecannula being mounted to the first manipulator.
 15. A method forpreparing for robotic surgery, the method comprising: manually moving afirst manipulator so that a first link of the manipulator moves toward adesired alignment with a surgical site; sensing an input displacement ofthe first link from an initial positional relationship relative to aplatform to a displaced positional relationship relative to theplatform, the input displacement resulting from the manual moving of thefirst manipulator; calculating a movement of a linkage in response tothe input displacement so that the first link of the first manipulatorreturns toward the initial positional relationship relative to theplatform, the linkage supporting the platform and the platformsupporting the first manipulator and a second manipulator; driving thelinkage per the calculated movement so that the platform follows thefirst link; and treating tissue at the surgical site by driving thefirst and second manipulators.
 16. A system for robotic surgery, thesystem comprising: a platform supporting the bases of the manipulators;first and second robotic manipulators supported by the platform, eachmanipulator having a manipulator linkage including a first link and adrive system operatively coupled to the manipulator linkage so as todrive the first link during surgery; a support structure supporting theplatform, the support structure including a support linkage including abase and a drive system operatively coupled to the support linkage so asto drive the platform relative to support structure base; a processorcoupling the manipulators to the support structure, the processor havinga platform movement mode, the processor in the platform movement modeconfigured to calculate a set-up command in response to a manualmovement of the first link of the first manipulator relative to theplatform and to transmit a platform movement command to the supportstructure so as to move the platform and the manipulators.
 17. Thesystem of claim 16, wherein the processor comprises non-transitorymachine readable code embodying instructions for determining an inputdisplacement of the first link of the first manipulator from a firstpositional relationship relative to the platform to a second positionalrelationship relative to the platform, the input displacement resultingfrom the manual movement of the first link, and for calculating themovement command so as to effect a desired movement of the supportstructure using the input displacement so that the orienting platformmoves while manually moving the first link.
 18. The system of claim 17,further comprising a manually articulatable linkage disposed between theplatform and the first manipulator, wherein the processor in theplatform movement mode allows manual articulation of the manuallyarticulatable linkage and inhibits articulation of the first manipulatorand drives the support structure so that the manipulator moves as asubstantially rigid body and the platform follows the first link duringthe manual movement of the first link.
 19. The system of claim 16,wherein the processor is configured to calculate the movement of thelinkage using a velocity of the first link relative to the orientingplatform, so that the driving of the linkage of the set-up structurereduces the relative velocity.
 20. The system of claim 19, wherein theprocessor is configured to calculate the movement command so that thevelocity of the first link relative to the orienting platform is reducedby a saturation velocity when the velocity of the first link relative tothe orienting platform exceeds the saturation threshold.
 21. The systemof claim 19, wherein the processor is configured to calculate themovement command so that, when the velocity of the first link relativeto the orienting platform moves the set-up structure toward anundesirable motion-limiting configuration of a set-up joint linkagebetween the manipulator and the orienting platform, the movement of theset up structure is resiliently urged away from the undesirableconfiguration.
 22. The system of claim 21, wherein the processor isconfigured to enter the platform movement mode in response to the set-uplinkage structure approaching or reaching the undesirable configuration.23. The system of claim 16, wherein each of the manipulators includes aninstrument holder and is configured to support an associated surgicalinstrument mounted to the instrument holder relative to a manipulatorbase, insert the associated surgical instrument along an insertion axisinto a patient through an associated remote center of manipulation (RC),rotate the instrument holder around a first manipulator axis thatintersects the associated RC, and rotate the instrument holder around asecond manipulator axis that intersects the associated RC, each of thefirst and second manipulator axes being transverse to the insertionaxis, the second manipulator axis being transverse to the firstmanipulator axis; wherein the set-up structure linkage comprises: amounting base; a column slideably coupled with the mounting base andselectively positionable relative to the mounting base along a firstsupport axis that is vertically oriented; a boom base memberrotationally coupled to the column through a shoulder joint operable toselectively orient the boom base member relative to the column memberaround a second support axis that is vertically oriented; an extendableboom member slideably coupled with the boom base member through a boomjoint operable to selectively position the extendable boom memberrelative to the boom base member along a third support axis that ishorizontally oriented, the orienting platform being rotationally coupledto the extendable boom member; and wherein the first link comprises oris adjacent to the instrument holder, wherein the calculated movementcomprises a movement of a plurality of joints of the set-up structurelinkage, and wherein the plurality of joints are driven per thecalculated movement so that the first link of the first manipulator hasthe preferred positional relationship relative to the manipulator base.24. The system of claim 16, wherein the first manipulator has anorienting platform movement input mounted thereon or adjacent thereto,the movement input normally in a first state and manually actuatable toa second state, and wherein the processor is configured to inhibitmovement of the orienting platform in response to movement of the firstlink when the movement input is in the first state.
 25. The system ofclaim 24, further comprising a cannula configured to mount to the firstmanipulator, wherein the processor is configured to inhibit movement ofthe orienting platform in response to the mounting of the cannula. 26.The system of claim 25, wherein the support structure linkage has aplurality of joints, and wherein the processor is configured to inhibitmovement along each joint of the set-up structure linkage with anassociated joint brake in response to the movement input being in thefirst state or in response to the cannula being mounted to the firstmanipulator.